| Mr Mark Matthew Mckell, OD | |
|
2100 Caldwell Blvd, Nampa, ID 83651-1510 | |
| (208) 466-6895 | |
| Not Available |
| Full Name | Mr Mark Matthew Mckell |
|---|---|
| Gender | Male |
| Speciality | Optometry |
| Experience | 20 Years |
| Location | 2100 Caldwell Blvd, Nampa, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396853974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | ODP-100119 (Idaho) | Primary |
| 152W00000X | Optometrist | 6271198-9934 (Utah) | Secondary |
| Provider Name | Salt Lake City Eye Care, LLC |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1952810731 PECOS PAC ID: 0941569719 Enrollment ID: O20180124001773 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Mark Matthew Mckell, OD 2100 Caldwell Blvd, Nampa, ID 83651-1510 Ph: (208) 466-6895 | Mr Mark Matthew Mckell, OD 2100 Caldwell Blvd, Nampa, ID 83651-1510 Ph: (208) 466-6895 |
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